Those of you who have dealt with a narcissistic wife or ex husband, or have been hurt by a narcissistic business partner know in your bones that such people are alive and well. Think about a difficult, self centered and self promoting person, who claims to think about others but almost always does what’s good for him. Does anyone come to mind? We label these self centered people - narcissists - every day. Yet, the authors of DSM 5 almost took NarcissisticPersonality Disorder out, only to leave it in at the last moment.

When your orthopedist looks as a broken femur he has a relatively simple task. You have only two femurs, so it is either the right one or the left one. The break may be simple or more complex. But most of us have the same anatomy surrounding our femur, the same joints, muscle construction and ligaments. There are thicker femurs and thinner ones, but the essential anatomy is the same. The doctor has easy ways to access damage. A physical examination often makes the diagnosis obvious. An X-Ray confirms the diagnosis in most cases. If the injury is subtle, an MRI can tease out what’s going on.

Personality Disorders do not have the diagnostic reliability of a broken femur, or of a strep throat or of breast cancer. Each of these has signs and symptoms, coupled with well proven laboratory tests that can verify what you are dealing with. While you can get any of these wrong – the breast cancer turns out to be benign, the broken femur turns out to be a side effect of steroid abuse – there is solid heuristic value to each label. Narcissistic Personality does not have this kind of diagnostic certainty and that’s what the controversy is really all about.

The brain has over 100 Billion neurons, and endlessly more connections between them. So, each brain is remarkably unique. Think about a face. It is a pretty simple structure. You have two eyes, a nose, a forehead, two cheeks, a mouth, two ears, some hair (or not), and a chin. Sounds simple; yet with some minor variations you find that no two faces are the same – with over 7 billion unique faces on the planet. Each brain has an unlimited number of differences that help to make a person what he or she is to become. The femur model does not really apply to personality.

In the world of psychiatricdiagnosis we do have disorders that come close, though. Most people with Obsessive Compulsive Disorder or Schizophrenia or Panic Attacks have much in common with each other. Our mental status exam and psychiatric evaluation come closer to the orthopedist and his broken femur. Neuropsychological testing reveals consistent pattern of thinking that indicate whether a person is say, psychotic or just obsessively anxious. Here psychiatry approaches the femur standard – but still falls way short. This is okay, because the human psyche is tougher to assess and highly unique – getting back to the 100 Billion neuron problem.

So, what about Narcissism?

As most of you know, narcissism fits in a psychiatric category called Personality Disorders. These folks have a maladaptive style of functioning in the world that can be hurtful to them or to others. Here is an abbreviated view of narcissism (with some minor alterations to make this character type clearer):

We all have elements of these traits. Some may argue that this list beautifully describes most healthy teenagers! Yet, what if an adult is truly trapped in this personality set? It can spell trouble for them and those who are their husbands, wives, business partners and children.

However flawed, the diagnosis of Narcissistic Personality Disorder has real value. You need to know what you are dealing with. And if you are the Narcissist, you will ultimately benefit from understanding why you go from failed relationship to failed relationship – and why you never have enough, despite your looks, money or success.

Every Narcissist is different. They each have a separate array of the 100 Billion neurons. They each have a different upbringing and they each have the above traits in varying degrees. The last criterion is one that I added, because in my experience, it is most critical. Most Personality Disorders lack the ability to look at themselves critically, as if from the outside. Criticism is too easily seen as an attack, and not a useful insight. Narcissists in this way are primitive psychologically. They just can’t be wrong.

Good therapy is about Meta-Cognition, which is the ability to watch yourself while you think. Great therapy helps the patient to go one step further. You ask a patient to Meta-Cognate, and then ask whether he really wants to continue to act the way he does. It is not easy, but we do have choices.

The Narcissist will try to please the therapist with her brilliance, warmth, or charm. She will stake out all the ways she has been let down by others and rationalize everything that she may do that is hurtful. In the world of divorce, for instance, a Narcissist may simply drop the marriage because “the love was not good enough” and then get outraged that her husband won’t just go along with it. After all, “isn’t it better that we both should be happy?”

She fails to see him as a person , and just assumes that he should feel the way she does. Then, she gets angry with him for being upset, avoids any criticism and may go so far as to feel justified in poisoning the kids against their dad. “The kids are better off without him.” Once she cuts bait, how he ends up is not her concern – relationships are ultimately chess pieces to be moved around. The loyalty you sometimes see in a good divorce exists only in her words, not in her deeds.

One scary point: People with NPD can be vicious when frustrated. Divorce regresses them further and sometimes domestic violence is possible. Whether you buy into the NPD diagnosis or not, it is dangerous to be a position of vulnerability with someone who feels justified in hurting you because he or she has lost control. Many women (and some men) can’t get their heads around the fact that someone who once loved them can hurt them (or their kids). Get help if you think this is your problem.

The downside to the diagnosis of Narcissistic Personality Disorder is that it can become a cheap catch phrase that you can use whenever you don’t like someone. It makes you feel superior because you have a label for him or her. It may be a sign of your own self importance if you reduce someone to a diagnosis. I buy into that.

So, does Narcissists exist?

In the fluid world of psychiatric nosology, I think the term Narcissist has value.

Here are some lessons that may be helpful:

1. Narcissists are people who are remarkably self-centered to the point of exploitation.

2. A Narcissist may be so entitled that he doesn’t even see himself as hurting others.

3. It is easy to be attracted to a Narcissist. They often possess admirable talents and looks. In my experience, many love romance – but not long term love.

4. If you have a lover, spouse or ex with these traits, just know that you may not count to her as much as you think. Knowing this can help protect you.

5. Yes, he may have loved you. He may be incredibly handsome, a great lover and an interesting person but notice how much of what he has done is self referential. He is far from selfless.

6. When it comes to love, most narcissists are more in love with love than in love with you.

7. Once the relationship is over, your history with him is not that important.

8. Many of these characters have a tough time getting older and good therapy can help them transition to being a better person. Generally, this happens when their beauty, wealth or accomplishments fail to work for them anymore.

9. The mid life crisis of a narcissist can be one of the more satisfying psychotherapies. They need love like everyone else; and better late than never.

10. Narcissists as a group have a powerful sense of urgency. They want a lot out of this life. And some of them make a real contribution to the worlds of acting, academics, religion, politics, science, literature and yes, psychology. Their pain is often internal – as in a relentless lack of satisfaction – and external – as in the debris of many failed relationships.

Narcissism is a useful term, even if it can be misused. It’s good to have words that can help you know what you’re dealing with. And, if you have these traits, knowing the full picture of narcissism may help you wake up to why you’re so chronically demanding – or empty. And, if your lover, friend, parent or spouse is narcissistic, you’ll have a better picture of what’s going on.

Caution: Not every hurtful person is a Narcissist. Sometimes he is just an A-hole. There is a difference.

Bottom Line: People with Narcissistic Personality Disorder are problematic people. They miss out on much of the subtle beauty of life.

I'm not a trained psychiatrist, but I have a few people in my life that are probably narcissists. I'm not sure it matters if narcissism appears in the DSM-5 or not. In fact, it doesn't matter whether anything appears in some book I have never seen or care to see.

As a member of the 7 billion people here on earth, what I need is a way to spot a problem and some coping skills to deal with the problem.

One of my dearest friends is a narcissist. He has a big opinion of himself and some really big ideas. Occasionally, he pulls off one of his big ideas. The world would be a lesser place without this man taking the huge risks that he does to complete his grand schemes. However, I can only take his company in limited doses, and since I know what motivates him I can cope with his behavior. I have a sister who also exhibits narcissistic traits, and since her actions have negative consequences I know to stay far far away from her. I also have another relative who has some pretty funky psychological behavior and I can recognize that for what it is too, although not narcissism I know the source of that problem too.

My life is what is and I can't do much to change it. In a perfect world I'd be living somewhere else and communicating with my family members by phone, but that is not my lot in life right now.

Perhaps the psychological industry should think about coming up with its own book outside of this scary DSM-5. The rest of us desperately need help dealing with the psychologically challenged, not an argument whether they exist or not.

PS: I got together with some friends yesterday, and we were comparing notes on the family behavior that occurred during the holidays. We were amazed at how we all experienced almost the identical bad behavior from our psychologically challenged relatives.

A parent with npd (or any of the Cluster B disorders) can do a hell of a lot of psychological damage to their child.

My own theory: those with Cluster B pds never grew out of the normal narcissistic phase of emotional development that very small children go through; they never achieve cognitive and affective empathy: the ability to care about the feelings and needs of others. They're like toddlers wearing the body of an adult like a costume, using their adult-level intelligence to rationalize and justify their egocentric, infantile perceptions and behaviors.

My mother had borderline pd (formally diagnosed) and narcissistic pd. She treated my Sister and me like inanimate objects. She developed fixed delusions about us and about our father and projected her own negative thoughts, beliefs and motivations onto us. I wasn't supposed to have any thought or feeling that she herself didn't have. (If she wasn't thirsty, then I could not possibly be thirsty, etc.) I wasn't supposed to cry when she raged at me and physically battered me; my crying would enrage her further. She firmly believed that I had hated her and rejected her as a mother when I was an infant; she felt resentment about having to care for me, particularly if I was ill or injured. I was subjected to nearly constant criticism and high expectations of achievement.

Mother wasn't able to take responsibility for making me physically afraid of her, and instead accused me of being cold and unloving toward her, believing that was true for the rest of her life.

She had awareness of these unhealthy, distorted ways of thinking and behaving yet persisted in them; Mother wrote in her therapy journal, "There must be something wrong with me, aren't mothers supposed to at least like their own children?" and "I wish I didn't have this need to get revenge on people." My dad, my Sister and I were subjected to mother's revenge behaviors; her need to "get back" at people scared me. Its an impossible situation for a child to be in: to attempt to bond with a parent who is too egocentric, too delusional, too emotionally disregulated and too cognitively distorted to have normal empathy, normal altruism, and normal maternal feelings for her own children.

It would help if the general public had more understanding about the traits and behaviors of the various mental illnesses so that those exhibiting such traits could be helped, and their children could be rescued from further emotional abuse and damage.

How is speaking the truth about my personal experiences of pretty severe emotional and physical abuse at the hands of my borderline pd/narcissistic pd mother being "belittling and demeaning? " Mental illness has a profoundly negative impact on the families of those who are mentally ill, not just on the person with the mental illness.

By sharing my experiences, I'm hoping that the psychiatric community will consider treating the Cluster B personality disorders as a *family issue*, if they realize that the children of moderately to severely disordered Cluster B individuals are experiencing very similar maltreatment that the children of drug and alcohol abusers are experiencing.

My experience is unfortunately not rare. If you check out the various Internet sites for the support of the adult survivors of personality disordered parents (particularly Cluster B parents) you will see many thousands of posts by thousands of members who endured very similar levels of abuse or neglect that I did.

Some kind of positive change, some revision of policy is needed RE protecting the children of Cluster B parents; its not just the person with the pd who suffers is my key point.

Annie,
There is a growing literature on children of narcissist parents.
I agree that the trauma of these childhood experiences are damaging.
And, we can do better in talking about this subject.
Too many kids suffer - and grow up with those memories.

Please know that I in no way mean to correct you.
Since I don't know your case, I can't really comment on it directly.
And since many read these comments, I wanted to put out the issue of how people sometimes misuse labels.
I certainly don't mean to imply that this applies to you.
Very sorry if I stumbled in my communication.

Anyway, I am very interested in the need to protect kids from abusive parents.
This is one reason that I started The Intelligent Divorce Project in the first place.

Thanks for your great blog, Dr. Banschick. As someone who has felt the burn of slander and manipulation from a narcissistic friend and colleague to whom I'd devoted a lot, hearing your views brings me comfort and understanding.

I'm wondering, are other typical traits of a NPD playing a victim when someone criticizes him or her, and blaming everyone for things that go wrong?

i know several people who exhibit narcissistic traits, and along with saying (and thinking) they're always right, they also blame others for their bad choices and play the victim constantly, especially if you give them the slightest criticism.

In my experience, the further down the narcissistic spectrum, the better they are at bypassing all responsibility and playing the dramatic, completely contrived victim. I have read this is a way to avoid the repressed shame that they feel...although sometimes it often doesn't look like shame. It looks like arrogance and entitlement.

Part of this is a process of projection. They place their unwanted self-criticisms onto others...so they will blame the victim for their own hurtful behaviors, in effect playing the victim for the very act in which they are the perpetrator. I am sure their lack of empathy strongly affects this process.

I was shocked to hear they almost took it out of the DSM V...I think its also a shame they've removed Passive Aggressive Personality Disorder.
I think by having a set of traits/symptoms with a cohesive name to identify with is the best way to begin to heal. Just like our physical bodies...otherwise there's too much guessing and not enough targeting. The problem I stuggle with is how mental illness is presented or described or perceived by the general public. The concept of Narcissist is so villified...it reinforces our intial urge to hate them and shut them out instead of teaching us why they've chosen to think and behave as they do and how to better manage our relationships with them (especially in the case of parental narcissism. I experienced parental narcissism and could not have safe relationships with my parents until I was out of their home/s and had created a safe and enjoyable life for myself...and once I understood that their inability to love me had nothing to actually do with me
I think maybe 're-branding' mental health diagnosis would help people to seek answers and heal hurts...especialy for those afflicted with narcissism since they are so deeply buried in denial and shame. My mother's entire life is one secret and lie after another...I cannot imagine how alone she must feel and despite attempts to reach her over the years she continues to choose what is familliar and 'safe'.

I have always found them repulsive and have been stunned and dismayed at how so many seemingly decent people will enable NPDs. But then, I grew up alongside one and suffered major internal damage as a result.

This society is becomming increasingly accepting and encouraging of NPD style behavior. Glad I won't be here much longer. You folks will be getting what you asked for... enjoy? lol

Other than keeping them at an emotional distance and finding others to fill those roles, how should we protect ourselves and help them especially if they're family? It's good to hear the support and experience of others, it can feel like nobody else deals with this.

I was looking foward to this ... but it appears you are still resting upon your cliches and prejudices, Mark

Take this bit;

"Here is an abbreviated view of narcissism:

• Exaggerated sense of one’s talents and importance
• Fantasies of great romance, great insight or great achievement
• Excessive need for admiration and attention
• Powerful sense of entitlement – can rationalize selfish acts as perfectly normal
• Tendency to use people as objects
• Lacks true empathy; but often can feign empathy quite well
• Easily hurt – and easily injures others (sometimes badly)
• Obsessed with oneself
• Lacks capacity to be self critical

We all have elements of these traits"
How can "Narcissists" be "them" (as in seperate from us) if "we" all have elements of these traits? The maintaining of this label also maintains the view of "narcissists" as a seperate species, "them", as in; not "us". This division keeps us in conflict with ourselves and stops us trying to mend the fractures in society that are caused by these conflicts. The whole "us and them" dichotomy promoted by the DSM and its disciples contributes to dysfunction and division. You need to ask yourself whether your role is one devoted to healing these divisions and dysfunction and if so, then you need to stop dividing "us" because it is inherently dysfunctional in itself.

Simon,
I enjoy your steadfastness. Look, there is no easy answer.
I will try an analogy, but I'm quite sure it will not satisfy you.

Light is both a particle and a wave.
It depends on your perspective.

Narcissism is a global human experience.
We all have elements, with infinite variations.
Yet, some people are locked into an enduring narcissistic style of action.
And, some of these people make others miserable and may suffer themselves.

It is worth having the NPD diagnosis to help them and others in their path.
It is worth critiquing the diagnosis, because humans are more complex than a label.

I kind of like this tension.
Its honest - and pragmatic at the same time.

I agree with the first bit. Just not with the last bit. I know I have tried to explain why before, but I’ll give it another go, from another angle;

If you’ve taken the time to have a wonder round my blog, you will have noticed that one of my main interests and motives for writing is to investigate the sources of conflict, whether relational or otherwise. The defence and protection of divisions has been extremely well demonstrated in the comments on your earlier entry on “Narcissists”. The divisions had important survival value for our distant ancestors. I have come to the conclusion that one of the greatest sources of conflict we have in the modern world is the phylogenetic tendency to divide and defend those divisions. Based upon a very primitive survival mechanism we instinctively divide others in to two groups; safe and danger. While this may have worked fine for our distant ancestors, I believe it is highly dysfunctional towards the social goals of modern humans; a peaceful, integrated society. We all want peace, happiness and contentment in our lives, yet, so often, we seem to manifest the complete opposite, why is this? Well the divisions that we are phylogenetically drawn towards create conflicts, whether they are divisions of self, divisions of groups, be they religion based, nationalistic, football teams, gangs or political bias. Our primitive phylogeny always ends up with the instinct to form an “us and them” dichotomy.

Nowhere is this more evident than watching the behaviour of primates, especially chimpanzees, when a rival group enters another groups territory; there is war. We like to see ourselves as far removed, superior and evolved from our cousins, but the reality can be seen in our religious or nationalistic wars, in the football terraces, gang wars AND in relationships. The veneer we wear over our phylogenetic heritage is thin indeed.

Division in relationships is major cause of relational disharmony and it is nearly always rooted in one or both partners being internally divided. By this I mean interrupted or incomplete neural integration so that the mind itself has conflicting needs that it cannot communicate to itself and find a solution to; an ongoing state of dissonance. These conflicts inevitably end up being projected on to the dynamics of any external relationship. The greatest source of our unhappiness occurs because of the paradox of loving; love itself can be a great source of fear. Love and fear are like opposite sides of a magnet, yet too often these two opposing drives are competing inside of us. The label “Narcissist” provides nourishment for the drive that causes us most misery in life; fear. And is a weapon that stabs love in the heart.

The Kraepelinian dynamic of the DSM is based on division. Not only does it artificially divide the diverse symptoms of our internal conflicts in to manageable taxonomies; artificial because almost everywhere these symptoms overlap or otherwise contradict the divisions yet people seem to turn a blind eye to these inconsistencies, but it also serves (for those less knowledgeable than ourselves?) to define a dichotomy between the “mad and the sane”, or the “ill and the healthy”. I’d almost go as far as to suggest that the very nature of the DSM is one based in narcissism, or at the very least, but perhaps unintentionally, one that promotes narcissistic values and gives the opportunity for some individuals to adopt a narcissistic podium with which to pontificate from. The myth of “The Narcissist”, especially in the relationship dynamic, panders to our very narcissism and provides a context from which to project out our internal divisions and conflicts on to the victims of our own narcissistic needs. No “label” contributes more to relational disharmony and conflict and division in relationships than that of “The Narcissist”. It’s just so blatantly convenient a label to use and is the most overused, misused and inherently dysfunctional of all labels in relationship dynamics.

I would sum it up by suggesting that the use of the term “Narcissist” as a branding label itself is in fact sourced in our own phylogenetic narcissistic roots.

If labels such as “The Narcissist” have any value at all, it is only as an emotional crutch for the emotional invalid and we would be better served convincing people they don’t need a crutch, especially one that keeps us divided and maintains opposition and conflict. Division is self defeating and defeating of the goal we all wish for in life; the peace, happiness and fulfilment of togetherness.

The job of anyone in the “mental health” field should be one that leads us all towards a contentment and fulfilment of life, for all “mental health” issues are essentially caused by discontentment and a stalling of life. The discontentment and stalling of life is both caused by and leads to divisions and oppositions.

For example, everyone carries fat on their bodies. Its normal and healthy to have a certain percent of fat as part of the total body weight. However, most people are not the "perfect" weight for their age, height, and sex, because they carry some excess fat. So technically, a great percentage of the population could be accurately referred to as "fat."

However the specific diagnostic term "morbidly obese" is useful to apply to someone when their body fat exceeds a certain percentage of their total weight, and its useful to apply the term because it then lets the person know that they need to LOSE the excess fat in order to be more HEALTHY and reduce their chances of acquiring the diseases and conditions associated with excess fat.

In the same way, narcissistic pd is a "shorthand" way of conveying the concept of an EXCESS of the normal and healthy trait of self-esteem (plus other traits and behaviors taken to an unhealthy extreme.)

Healthy self-esteem allows us to feel that we are just as good and deserving as other people; it helps us do proactive, healthy things for ourselves and for others.

Excess self-esteem however makes a person feel superior to others, entitled to special, preferred treatment, and feel justified in treating other people with disdain or contempt because they are "inferior." And coupled with a lack of affective empathy, excessive self-esteem results in a person who can do great damage to other people.

The worst-case scenario of excessive self-esteem combined with a lack of empathy, plus lack of remorse, plus lack of a conscience, is psychopathy.

So I see creating labels (such as adolescent, middle-class, morbidly obese) as just a shorthand way of referring to a specific set of conditions, factors or behaviors, instead of laboriously listing and describing each and every trait/factor/condition separately.

I have read of two separate basic forms of narcissistic pd; Randi Kreger wrote an article about that here at Psychology Today.

One form is the "invulnerable narcissist": someone who truly does have extremely high self-esteem due to being treated like a little god by adoring parents. Nothing is too good for their Golden Child, and the child is rarely if ever punished for any wrongdoing. Such Golden individuals come to regard preferential treatment as deserved and natural, due to their superior status, and come to regard other people as mere objects or slaves: inferiors who exist only to service their needs. In Asian cultures its called "The Little Emperor" syndrome.

The other form is the "vulnerable narcissist": such individuals actually have extremely low self-esteem, but create a false persona of bravado and superiority, or even highly controlling, domineering behavior (even cruelty) toward others, to mask their true feelings of inferiority.

And I still say that there's nothing wrong with referring to a collection of traits or behaviors with a shorthand "label." Its silly to say, "My heart is light, my eyes are crinkling at the corners and my mouth is turned up and I feel like laughing" instead of just using the "label" or short-hand version: "I'm so happy!"

I have a lot of respect for Randi. An acquaintance of mine (I like to think of him as a friend as we have had a lot of communication over the years) co-authored with Randi; "The Stop Walking on Eggshells; workbook".

I'd have to disagree with her dichotomy as presented above, though ...

Simon have you grown up with NPD parents?? If you didn't experience this, don't bother to go there, Simon. If you're trying to heal, it damn well needs to be us and them! How helpful to have the criteria for such people. True narcs will never heal, again, if you think they truly can, you don't know what you're dealing with, but they're fantastic at harming everyone else in the course of trying to heal their false selves. Of course there's a continuum, but if they're high end, no contact only way. To do other is waste of time/possibly masochistic/naive/plain hopeful against the odds...

Dr. Banschick,
The question that I have a difficult time reconciling: Do narcissists ever appear deeply noble, such as being an advocate and leader for a very good cause, but then can also have a capacity for these traits, too? The person who I know fits every criteria and description in this post, but then has the most noble public personna that it baffles me.

My bf has joked with me a few times that he might be a narcissist. I think he jokes about it because he might have some genuine concerns about it. I have noticed that he does not initiate texting or emailing me, I am usually the one doing it and he rarely askes about MY day. However, in person, things seem to be different and he is more caring. He is also very concerned about his appearance, lifting weights, etc., maybe a bit too much. I sometimes don't feel cared about enough and I wonder if he might be a narcissist to some degree. How will I know?

I recently read an article on Schizophrenia that stated that referring to a person with symptoms of schizophrenia as "A Schizophrenic" was morally akin to referring to a black person by using the "N" word. I think this also really sums up my position on the use of the term "A Narcissist". I guess it's all about the motive and intent of the person. In its prolific modern use it becomes a derogatory and slandatory term. We are all guilty of narcissism and destructiveness to a certain degree and we can all be “A Holes” sometimes, it would do us all well to remember that.

We like to present ourselves as "spotlessly white" and that prejudicial perception is often assisted by painting others as blacker than they actually are.

So, then, what politically correct term should people use when referring to the traits and behaviors of narcissistic pd?

It takes WAY too long to say, "You are exhibiting extreme grandiosity, complete self-absorbption, a lack of empathy and compassion for the feelings of others, and you seem to feel entitled to receive superior treatment without having earned such deference...again; so cut it out!"

I think saying "You're being an asshole again; cut it out." gets the point across but is terribly insulting and derogatory.

So, what shorthand term DO you suggest that people use when referring to npd traits and behaviors?

It's interssting to note, Annie, that both your "longhand" examples provided are describing an expression of behaviour and both imply that the behaviour is of the moment.

I have no problem with the terms "narcissistic" or "narcissism" to describe behaviour. It's the terms "a narcissist" that becomes dehumanising when it is expressly used with that intent in mind. The motive is what is important; you can describe someone's behaviour as narcissistic because that may be exactly the way they are behaving, but as soon as it becomes "a narcissist" then the core motive is to dehumanise them and justify yourself and your own narcissistic attitudes, actions and behaviours towards them. Or to put it another way; "it's OK for me to be an arsehole towards them, because they were an arsehole first.".

If someone chronically, on a daily basis, acts like a narcissist by exhibiting narcissistic traits and behaviors, then that is not a behavior of the moment, so I would refer to that person as *a narcissist.*

And if someone is morbidly obese, then that is not simply a behavior of the moment, either: it is (barring other medical conditions/issues) due to chronic overeating resulting in morbid-level obesity. They're carrying excess fat and that means an earlier death and a poorer quality of life.

The fat person has a problem controlling his calorie intake vs output, which is indulged at the expense of his quality of life, and the narcissist has a problem controlling his grandiosity and self-absorption, which is indulged at the expense of other's needs and feelings.

I don't think it helps to tiptoe on eggshells if you genuinely care about someone's welfare. I think addressing an issue directly, openly and honestly is the way adults solve problems.

I don't see how it's dehumanizing to assign a label to this. You seem to think these are just minor aspects of what a person does and it's blown out of proportion to put someone down. Not at all. If you haven't met a narcissist you have no idea how destructive they are. While some people may have some elements (we don't all have all of those traits, btw), it's off the charts in narcissists. I think it helps to assign a label to the disorder so I can learn how to deal with the individuals with this better, just like I try to understand any other disorder or symptom of disease. I'm sure I can't change them but I can alter my expectation and reaction. That is not being an arsehole.

I am acutely aware at how destructive humans can be. I am also aware of how and why that destructiveness manifests. It's been something that I have been studying, almost exclusively, for the last 10 years.

Telling me I haven't met "a narcissist" is a little bit silly, because clearly the definition is subjective; people I have had in my life might easily fall well within what you define as "a narcissist". It's just that I don't define them as "a narcissist" because I have learnt and understand the root cause and motive of their destructive behaviours.

It may help you to assign the label, but it doesn't help me, because I don't want to learn how to avoid these broken people, I want to learn how to help them.

An important perspective on this is one of phylogeny; Annie, it is clear from other posts that you still carry a considerable wound from someone that you consider was “a Narcissist”. Anonymous, I think that probably goes for you too. I too carried my own wounds until I learned the means to heal them.

Evolution, not just human evolution, but in just about every other animal on the planet, has brought about the perspective that if we are wounded by someone, then that someone (or animal) is a bad. This is simply the way our perspective evolved as part of the larger scheme of species survival. The effect we are seeing here (and in all other manifestations of this effect) is simply evolutionary programming, a programming that we are tied to unless we can escape those shackles and that can only come by expanding one’s perspective and growing out and away from our phylogenetic programs. It is clear from all the conversations on here that those that NEED these labels more than anyone else are the wounded ones that have yet to learn how to heal, and that need to see those that have wounded them as less than human. Until you can let go of that programming, your wounds won’t heal, because it is that very programming that keeps those wounds fresh and open.

How predictable that your latest post exudes such a condescending, superior tone, admonishing me to "let go of my programming" while making assumptions about me, and lecturing me, just because you can't refute my logical argument and because I disagree with you. I guessed that you would probably respond in this way. How perfectly narc..... nope, I'm not going to say it! Draw your own conclusions.

I am very sorry if you thought my comment was in anyway condescending or admonishing towards you. that was not my intent. My main area and interest is developmental neurobiology and the phylogenetic neurobiological roots of our negative behaviours. My comments were not specifically aimed at you, but aimed at the human race in general and the dysfunctions we have inherited from our distant ancestors on the evolutionary journey of our species. The things Jung referred to as "our saurian tail" or "Shadow".

"Taking it in its deepest sense, the shadow is the invisible saurian tail that man still drags behind him."

May I suggest you look in to (if you haven't already, and if you have you might perhaps give it a second look) Jung's "Undiscovered Self". While still using the language of 20th Century psychoanalysis, he still, accurately, puts the finger on the source of our individual and collective destructive impulses as buried deep within our phylogeny. Although it is not really a tail, but rather core central structures of our brains that we share with all other animals.

Or, if it is easier for you, you can just dismiss me as a narcissist. :-)

This is my first visit but upon reading the posts and the final back and forth on the term narcissist I have to agree with Annie, MB and anonymous. It is simply a term like any other that helps depict the chronic nature of the traits. It does not have to be linked to a need to put others down or anything more. Thinking you can know or to assume that you know someone else's intent is a rudimentary problem of the very subject matter discussed here. That is sounds like the narcissistic behavior or mindset being discussed.

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I definitely agree that Narcissistic Personality Disorder exists, yet I also believe personality disorders are diagnosed too frequently. So another question would be how do we increase the effectiveness of the manual in order to assist professionals to make a better diagnosis.

NIMH (which funds the development of the DSM, or Diagnostic and Statistical Manual for the psychiatric profession) has started developing a new kind of psychiatric diagnostic and treatment manual, that will be called the RDoC, or Research Domain Criteria. Eventually this new manual will replace the DSM; its debut is at least a decade away, though.

The intent of the RDoC is to provide more scientifically valid and precise diagnostic method and more effective treatment for psychiatric conditions, based on more of a medical model. You can read the article at this link; its by Dr. Insel, the head of NIMH:

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